RECONSTRUCTION MORPHOSTRUCTURAL ANALYSIS OF FIBULA BONE OSTEOTOMIES WITH PIEZOSURGICAL DEVICE IN JAWS RECONSTRUCTION: A MIRROR OF A NEW FASTER PIEZOELECTRICAL OSTEOTOME

BACKGROUND: Segmentation of vascularized bone flaps with piezoelectrical device is a valuable alternative to conventional cutting methods because it improves the intraoperative safety of the procedure. The time needed for completion of a single osteotomy with the piezoelectric device is longer than with the oscillating saw. However, the time normally needed to dissect and protect both the periosteum and the pedicle at each osteotomic site is greatly reduced. In 2015 a new piezoelectrical device suitable for highly mineralised bone and significantly efficient through all the cutting depth was engendered. Hardness and thickness of human fibula bone cortex may be fitting for this new piezoelectrical osteotome. AIM: We present and discuss the use a new generation of the piezoelectric bone-cutting device in microvascular free bone flap for the reconstruction of jawbone defects. The aim of this study was to evaluate on human fibula the time required for completion of each osteotomy comparing new piezoelectrical device and previous commercial device. A comprehensive study that evaluates and compares histomorphometry and histology of bone surfaces created with two piezosurgical devices is carried out. MATERIALS AND METHOD: In 2016 seven consecutive patients underwent microsurgical reconstruction of the jaws. One specimen from each fibular bone diaphysis was harvested with the piezoelectric device and histologically evaluated. CONCLUSIONS: The new generation piezoelettrical device halves the time needed for linear and wedge osteotomies on human fibula flap compared to tradizional piezoelectrical device. No significant histological and histomorphometrical differences are detected between bone surfaces osteotomized with both devices.